Effect of statins on lipoprotein (a) in dyslipidemic patients

Irudayam, Joel Bijou; Sivaraj, Rajeshwari; Nirmala, P

doi:10.5455/2319-2003.ijbcp20141213

Cited by 6 publications

(4 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While the limitation of our single-arm analysis in including only trials in which statins and fibrates were concomitantly studied should be considered, a possible reason for the observed increase in plasma Lp(a) concentrations could be attributed to the effect of rosuvastatin. There is evidence from previous trials indicating that, unlike atorvastatin and simvastatin, rosuvastatin therapy may significantly increase plasma Lp(a) levels [ 68 , 69 ]. This is consistent with the results of our single-arm analysis, as excluding the only arm with rosuvastatin [ 65 ] from the analysis resulted in a non-significant overall effect of statin therapy on Lp(a) levels.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the effects of fibrates versus statins on plasma lipoprotein(a) concentrations: a systematic review and meta-analysis of head-to-head randomized controlled trials

Sahebkar

Simental‐Mendía

Watts

et al. 2017

BMC Med

View full text Add to dashboard Cite

BackgroundRaised plasma lipoprotein(a) (Lp(a)) concentration is an independent and causal risk factor for atherosclerotic cardiovascular disease. Several types of pharmacological approaches are under evaluation for their potential to reduce plasma Lp(a) levels. There is suggestive evidence that statins and fibrates, two frequently employed lipid-lowering drugs, can lower plasma Lp(a). The present study aims to compare the efficacy of fibrates and statins in reducing plasma concentrations of Lp(a) using a meta-analysis of randomized head-to-head trials.MethodsMedline and Scopus databases were searched to identify randomized head-to-head comparative trials investigating the efficacy of fibrates versus statins in reducing plasma Lp(a) levels. Meta-analysis was performed using a random-effects model, with inverse variance weighted mean differences (WMDs) and 95% confidence intervals (CIs) as summary statistics. The impact of putative confounders on the estimated effect size was explored using random effects meta-regression.ResultsSixteen head-to-head comparative trials with a total of 1388 subjects met the eligibility criteria and were selected for this meta-analysis. Meta-analysis revealed a significantly greater effect of fibrates versus statins in reducing plasma Lp(a) concentrations (WMD, –2.70 mg/dL; 95% CI, –4.56 to –0.84; P = 0.004). Combination therapy with fibrates and statins had a significantly greater effect compared with statin monotherapy (WMD, –1.60 mg/dL; 95% CI, –2.93 to –0.26; P = 0.019) but not fibrate monotherapy (WMD, –1.76 mg/dL; 95% CI, –5.44 to +1.92; P = 0.349) in reducing plasma Lp(a) concentrations. The impact of fibrates versus statins in reducing plasma Lp(a) concentrations was not found to be significantly associated with treatment duration (P = 0.788).ConclusionsFibrates have a significantly greater effect in reducing plasma Lp(a) concentrations than statins. Addition of fibrates to statins can enhance the Lp(a)-lowering effect of statins.

show abstract

Section: Discussionmentioning

confidence: 99%

Comparison of the effects of fibrates versus statins on plasma lipoprotein(a) concentrations: a systematic review and meta-analysis of head-to-head randomized controlled trials

Sahebkar

Simental‐Mendía

Watts

et al. 2017

BMC Med

View full text Add to dashboard Cite

show abstract

“…Statins, while effective at lowering LDL cholesterol (LDL-C), do not reduce Lp(a) levels and may even increase them slightly (5)(6)(7)(8)(9)(10)(11)(12)(13). In addition, the reduction of LDL-C with statins has been shown to markedly decrease or attenuate the CVD relationship with Lp(a) (14).…”

Section: In Vivo and In Vitro Analysesmentioning

confidence: 99%

PCSK9 inhibition-mediated reduction in Lp(a) with evolocumab: an analysis of 10 clinical trials and the LDL receptor's role

Raal

Giugliano

Sabatine

et al. 2016

Journal of Lipid Research

192

113

View full text Add to dashboard Cite

This article is available online at http://www.jlr.org tion with LDL and PCSK9 and reversed by adding PCSK9 mAb. These studies support that reductions in Lp(a) with PCSK9 inhibition are partly due to increased LDLR-mediated uptake. In most situations, Lp(a) appears to compete poorly with LDL for LDLR binding and internalization, but when LDLR expression is increased with evolocumab, particularly in the setting of low circulating LDL, Lp(a) is reduced.-Raal, F. J., R. P. Lipoprotein (a) [Lp(a)] is an LDL-like particle consisting of hepatic synthesized apo(a), a plasminogen-like glycoprotein that is disulfide-linked to the apoB moiety of circulating LDL, most likely at the hepatocellular surface (1). Lp(a) levels are highly variable, primarily genetically Cincinnati, OHAbbreviations: CD36, cluster of differentiation 36; LDL-C, LDL cholesterol; LDLR, LDL receptor; Lp(a), lipoprotein (a); Lp(a)-C, lipoprotein (a)-cholesterol; LPDS, lipoprotein-deficient serum; LRP1, LDL receptor-related protein 1; mAb, monoclonal antibody; PCSK9, proprotein convertase subtilisin/kexin type 9; Q1, quartile 1; Q2W, every 2 weeks; Q3, quartile 3; QM, monthly; SOC, standard of care; SR-B1, scavenger receptor class B member 1; VLDLR, VLDL receptor.

show abstract

“…Patients taking atorvastatin in one study showed decrease in Lp(a) levels by 18.73% while those taking simvastatin only showed 3.15% reduction, and rosuvastatin showed elevation in Lp(a) levels by 8.58%. [23] Another study reported 18-55% reduction in LDL by statins, 7-30% decrease in TG and an increase in HDL by 5-10%. [24] According to a literature review, statins can decrease LDL levels by 25-60%.…”

Section: Discussionmentioning

confidence: 99%

Association of lipoprotein (a) with lipid profile and response to statin treatment in hyperlipidemic patients

Abid¹,

Nadeem²

2022

J Pak Med Assoc

View full text Add to dashboard Cite

Objectives: To determine serum levels of lipoprotein(a) in the local population, its relationship with other parameters of lipid profile and statins’ response to lipoprotein(a). Method: The cross-sectional analytical study was conducted at the Pak-Emirates Military Hospital and Army Medical College, Rawalpindi, Pakistan, from March 2018 to March 2019, and comprised healthy controls in group I, persons with hyperlipidemia without medications in group II, and diagnosed cases of hyperlipidemic on statin therapy in group III. The samples were studied using enzyme-linked immunosorbent assasy for lipoprotein(a) estimation, and an automated chemistry analyser for lipid profile estimation. Data was analysed using SPSS 21. Results: Of the 90 subjects with a mean age of 43±5 years, 30(33.3%) were in each of the three groups. Mean body mass index, total cholesterol, triglycerides and low-density lipoprotein were significantly different among the groups. Lipoprotein(a) level was not correlated with statins (p>0.05), but had a positive correlation with low-density lipoprotein. Conclusion: Lipoprotein(a) was found to be raised even in the absence of dyslipidemia, and it was controversially raised with statin therapy. Lipoprotein(a) can very well be regarded as an independent risk factor for all the known complications of hyperlipidemia. Key Words: Hyperlipidemia, BMI, Statins, Lipid profile, Lipoprotein(a).

show abstract

Effect of statins on lipoprotein (a) in dyslipidemic patients

Cited by 6 publications

References 16 publications

Comparison of the effects of fibrates versus statins on plasma lipoprotein(a) concentrations: a systematic review and meta-analysis of head-to-head randomized controlled trials

Comparison of the effects of fibrates versus statins on plasma lipoprotein(a) concentrations: a systematic review and meta-analysis of head-to-head randomized controlled trials

PCSK9 inhibition-mediated reduction in Lp(a) with evolocumab: an analysis of 10 clinical trials and the LDL receptor's role

Association of lipoprotein (a) with lipid profile and response to statin treatment in hyperlipidemic patients

Contact Info

Product

Resources

About